Healthcare Provider Details

I. General information

NPI: 1245552512
Provider Name (Legal Business Name): SAISAI INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2010
Last Update Date: 03/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

252 W STATE ROAD 434
LONGWOOD FL
32750-5114
US

IV. Provider business mailing address

252 WEST S.R. 434
LONGWOOD FL
32750
US

V. Phone/Fax

Practice location:
  • Phone: 407-332-9753
  • Fax:
Mailing address:
  • Phone: 407-332-9753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH24471
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: KETAL KAPADIA
Title or Position: PHARMACY MANAGER
Credential:
Phone: 407-474-3393